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Browsing by Author "Moreira Marques, T"

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  • Medicina Interna: o Passado, o Presente e o Futuro. A Visão do Interno
    Publication . Moreira Marques, T
    O presente artigo é um exercício de reflexão um interno sobre a evolução da especialidade, desde o seu passado, passando pelo presente e pensando o futuro. Tem como objectivo promover a reflexão e discussão interpares sobre a evolução da especialidade, os objectivos comuns para o futuro e, ainda, a importância da revisão das necessidades de formação e curriculares nesta especialidade.
    2021-07Journal article Open access Show more
  • Recurrent Klebsiella Pneumoniae Infection Causing Transcatheter Aortic Valve Implantation (TAVI)-Related Endocarditis
    Publication . Tosatto, V; Cruz, C; Ferreira, T; Moreira Marques, T; Boattini, M; Almeida, A; Barata Moura, R
    The authors report the case of an 86-year-old woman presenting with recurrent Klebsiella pneumoniae bacteraemia. She had severe aortic stenosis submitted to a recent transcatheter aortic valve implantation (TAVI). Initially, Klebsiella pneumoniae bacteraemia from a urinary source was diagnosed. Following another 4 episodes of bacteraemia with the same agent, the source was ultimately found to be a periprosthetic abscess. Considering the patient's unsuitability for surgery, a decision was made for life-long antimicrobial therapy. This approach has been successful in preventing recurrences or complications. Endocarditis is one of the most severe complications seen following TAVI, often carrying a poor prognosis. Even though Klebsiella spp. are common pathogens for healthcare-associated infections among the elderly, they are seldom the causative agent for endocarditis. Being the first reported case of TAVI-related Klebsiella endocarditis, it was successfully managed using a medical approach.
    2020Journal article Open access Show more
  • Weil's Disease in a Young Homeless Man Living in Lisbon
    Publication . Moreira Marques, T; Nascimento, P; Almeida, A; Tosatto, V
    Leptospirosis is a zoonotic disease of worldwide distribution caused by infection with Leptospira genus bacteria, a pathogenic spirochaete. We present the case of a 29-year-old man admitted to our hospital with fever and multiorgan failure. He provided poor information about his symptoms. No recent travel or occupational history was reported and his clinical presentation did not suggest any infectious foci. His relatives later disclosed that he had been homeless for 3 weeks in the context of behavioural changes, obtaining foodstuff from waste containers and water from rain puddles. In the setting of this epidemiology, his presentation of fever, jaundice, acute renal injury and thrombocytopaenia suggested leptospirosis. Prompt empirical antimicrobial coverage was started, alongside organ support therapy. The diagnosis was later confirmed through microscopical and molecular methods. The patient made a full recovery. Leptospirosis should be considered early in the diagnostic work-up of any patient with acute febrile illness with multiorgan system involvement, with the identification of risk factors being essential to treat early in development of the disease.
    2020Journal article Open access Show more